Background: There is increasing interest in the use of telemedicine as a means of health care delivery especially in circumstances of pandemics. This is partly because technological advances have made the equipment less expensive and simpler to use and partly because increasing health care costs and patient expectations have increased the need to find alternative modes of health care delivery. Introduction: Telemedicine and telepsychiatry, in particular, are rapidly becoming important delivery approaches to providing clinical care and information to patients in cases wherein the medical resources and the patients are very hard to be brought together with respect to rules of behavior in case of epidemics. The reliance on technology to bridge the obstacles between the patients (consumers) and medical resources (providers) can create problems that impact service delivery and outcomes, but in cases such as this (COVID-19 pandemics), this is virtually the only tool for providing clinical care and information to patients. Materials and Methods: A client satisfaction survey was undertaken in a daily hospital (a part of University Clinic of Psychiatry in Skopje). The anonymous modified self-report questionnaire (short form patient satisfaction questionnaire [PSQ-18]) covering demographic, gender, and age variables was endorsed by 28 participants. The mean age of the subjects was 40.25-22 years, with a small majority of men (18 participants) versus women (11 participants). Results: Overall satisfaction with psychiatric care was high (80.22%). None of the demographic or other variables correlated significantly with satisfaction. Discussion: We had to reduce rate and time length of our face-to-face contacts with patients as a result of pandemics but they were able to reach their doctors virtually at all times. Conclusions: Many mental health professionals are using widely available, commercial software downloaded from the internet to provide care directly to a patient's home.
OBJECTIVES: One of the main objectives of this paper is to analyze the associations between childhood abuse, household dysfunction and the risk of attempting suicide among young adolescents in the country.METHOD: A representative sample consisted of total 1277 students (58.6% female and 41.6% male), aged 18 and above in year four of 664 secondary school and 613 first- and second-year university students. The data were obtained using Adverse Childhood Experiences Study Questionnaires (Family Health History Questionnaire) for collecting information on child maltreatment, household dysfunction and other socio-behavioural factors, applying WHO/CDC-recommended methodology. Statistical significance was set up at p<0.05.RESULTS: Emotional neglect, physical abuse and physical neglect were the most frequent abusive experiences students had. Overall, suicide attempts were reported by 3.1 % of respondents (4.7% by females and 0.8% by males). Those respondents who had been emotionally abused were almost three times as likely to attempt suicide, physical abuse almost doubles the chances of attempting suicide, substance abuse in the family increased the chances 2.3 times for attempting suicide, violent treatment of the mother almost quadrupled them for attempted suicide, having a family member who had been in prison increased the odds of almost 3.5 times for attempting suicide. Attempted suicide was found to be 1.5 times more likely as the number of ACEs reached 3 and 3.4 times more likely as the number of adverse childhood experiences reached four or more. CONCLUSION: Identifying and treating children, adolescents and young adults who have been affected by adverse childhood experiences may have substantial value in our evolving efforts to prevent suicide
The region, which consists of the countries of Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Kosova, Macedonia, Montenegro, and Serbia, takes its name from the mountain range, the Balkans. The Balkans, a Turkish word for "chain of wooded mountains," covers an area of 700,000 km(2) region in Southeastern Europe and is home to over 55 million inhabitants. A decade of war and ethnic fighting in the 1990s destroyed the medical systems in place, creating a desperate need to rebuild a modern healthcare infrastructure. Telemedicine has been shown to be an effective tool in this regard. The adoption of telemedicine in the Balkans is firmly under way. Since its inception in 2001, the International Virtual e-Hospital (IVeH) has promoted the design, growth, and implementation of telemedicine in a variety of developing countries across the globe. Successful implementation of telemedicine in any region is based on a number of factors, each of great importance. However, one that is key is the education and training of community leadership. Over the past several years, the IVeH has held intensive seminars in the region to promote the application of telemedicine as an effective tool in healthcare modernization. This includes the First Intensive Balkan Telemedicine and e-Health Seminar in Prishtina, Kosova (2002) and the Second Intensive Balkan Telemedicine and e-Health Seminar in Tirana, Albania (2007). Recently, the third installment of these seminars was held in Skopje, Macedonia (February 2009). These three seminars have provided a fertile foundation for telemedicine to emerge as a significant tool in enhancing healthcare in this region. Each has broadened the understanding of the immense capability that telemedicine can offer and has acted as a catalyst for the development of telemedicine in the region. The Republic of Macedonia is the latest country to invest in telemedicine, having a formal commitment from the Ministry of Health to establish a national telemedicine effort. The following is a summary of the Third Intensive Balkan Telemedicine and e-Health Seminar.
Domestic and peer violence in Macedonia is similar to other developed nations. It is present among adolescents and their families. A study was conducted on 664 secondary school students throughout Macedonia. The results indicated that 11.2% male and 16.54% female students often face different kinds of family violence. Peer violence of different forms is marked as "often" in 8.04% male respondents and 5.63% female respondents. One of possibilities in preventing this negative phenomenon is the application of telemedicine. There is a growing body of evidence that the use of telemedicine offers a good tool for mental healthcare in underserved communities, and that these services are as effective as face-to-face work with adolescents. By building an effective telemedicine network in Macedonia, both victims (adolescents) and their parents could be given a chance to contact proper institutions for help with more confidence and less stress.
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